International Journal of Healthcare Simulation

Background:

Physical health emergencies that occur in acute mental health settings are not frequently seen. This may lead to delays in patients receiving appropriate care [1]. Simulation is an underused training modality in mental health [2] and there are currently only a few courses that address this area. (https://www.hee.nhs.uk/sites/default/files/documents/RAMPPS%20course%20handbook.pdf).

Recognition and management of physical emergencies in mental health can be simulated and can focus on both technical and non-technical skills [3]. We aimed to facilitate simulation of physical health emergencies designed for staff who work within acute mental health settings. Opportunities for staff to simulate management of these scenarios in a safe environment with a view to improve their practice, improve patient safety and reduce mortality.

Methods:

Psychiatry and Emergency Medicine healthcare professionals were involved in developing scenarios to ensure key learning objectives were met. Five physical health scenarios were simulated based on real life cases where improvement in their recognition and management was needed (e.g. significant incidents). These were deliberate self-harm, acute stroke, sepsis, fractured neck of femur, and cardiac arrest. A combination of actors and manikins were used. Eight candidates attended the one-day course and were given equal opportunity to manage a scenario as if it were taking place in their own place of work. Candidates remained in the capacity in which they normally work, drawing on their existing skills and knowledge. Faculty members delivering the course all had significant emergency medicine experience and their current roles were in emergency medicine. Candidates were initially orientated to the simulation laboratory including a high-fidelity manikin. An introductory session discussing human factors was then delivered before the candidates progressed to the scenarios.

Findings:

Formal feedback was completed at the end of the session. All candidates found the experience enjoyable, found it relevant to their work, and found the scenarios challenging. All candidates agreed that this sort of training would improve patient safety and that the training should be repeated for others. The main limitation was that some medical equipment was different to what the candidates would use in their own place of work.

Conclusion:

Management of physical health emergencies in the mental health setting can be successfully demonstrated by simulation. This session provided a safe learning space for all of the candidates to demonstrate both technical and non-technical skills in a supportive environment.

References

1. Mwebe H. Physical health monitoring in mental health settings: a study exploring mental health nurses’ views of their role. Journal of Clinical Nursing. 2017;26(19–20):3067–3078.

2. Lavelle M, Attoe C, Tritschler C, Cross S. Managing medical emergencies in mental health settings using an interprofessional in-situ simulation training programme: a mixed methods evaluation study. Nurse Education Today. 2017;59:103–109.

3. Peate, I. Using Simulation to enhance safety, quality and education. Journal of Paramedic Practice. 2011; 3(8):429.